I had my consultation with my radiation oncologist yesterday which went well. Dr. Tsuji spent well over an hour with me taking my history and explaining the process and side effects of radiation therapy. It’s always extra comforting when a physician comes in having already reviewed your chart and having an individualized plan in mind.

Although I had an excellent response to chemo and the post-surgical pathology shows that there was no residual cancer in the tumor bed or the lymph nodes, radiation is important with breast-conserving surgeries to get rid of any cancer cells that may remain in other areas of the breast that weren’t removed (as they would have been in a mastectomy). So, Dr. Tsuji recommends 4 weeks of whole-breast radiation (no axillary radiation since nodes were clear) with a boost to the tumor bed. After everything’s been set up, I’ll go for radiation 5 days per week, likely starting the 2nd or 3rd week of January.

Birthday stay-cation! Thankful to have many options to “get away” in Honolulu!

The side effects of radiation therapy are fatigue, which generally increases as the treatment progresses, and skin irritation which is basically like a bad sun burn. With radiation to the breast, the radiation oncologist takes as much precaution as possible to minimize radiation to the lungs and the heart. One way to protect them is to perform a breath hold during the treatment to raise the breast tissue away from the organs as the lungs expand and so we may see how that goes when I do my simulation in a few weeks.

I also need to be sure my left arm range of motion improves before I can start radiation since I’ll likely be positioned lying on my back with my hands behind my head. I can get there now, but it’s not at all comfortable due to the cording. My PT did work on it last week and it got significantly better after just one treatment, but it’s not quite there yet so I have some goals in the next few weeks!

I’ll see my oncologist on Thursday for a post-surgical follow up and planning and will see my surgeon after that to have my bandages removed from my port surgery. Thankfully, all is going well and everything is healing up nicely. Overall, I’m feeling well but definitely looking forward to being able to be more active again. I’m thankful to be on the last stretch of treatment and starting the new year cancer free!

Aloha ❤

Surgery Update

Surgery Update

Hey everyone- hope you’re all having a good week! I had a few people text me about the results of my MRI & surgery consult so I figured I better update you!

I did my MRI two weeks ago and they took images with and without contrast. The good news is that the mass that was present on the ultrasound did not “light up” on the MRI so we’re hopeful that small mass is just scar tissue rather than residual cancer cells. However, we will not know for sure until the mass is removed and sent to pathology after surgery.

I met with my surgeon on Monday, and we agreed to go forward with breast-conserving surgery (aka “lumpectomy”). She will also do a sentinel lymph node biopsy to be sure there is no cancer in the lymph nodes. We are planning for surgery on November 27 as long as my pesky white blood cell count comes back up – it was really low last week again. I better enjoy my Thanksgiving dinner because no eating after midnight!

From what I know now, I’ll check in early in the morning and will have a radioactive dye injected into my left breast. The dye traces the circulation from the tumor itself to the lymph nodes. The surgeon will then remove the first node to which the tumor drains as well as any other lymph nodes which may contain cancer cells.

Once the nodes are removed, they are sent to pathology to determine how many contain cancerous cells. If there are cancerous cells in a majority of the nodes, the surgeon may choose to remove additional nodes while I’m still under anesthesia. Otherwise, she will remove the mass and that will be that!

The recovery should be relatively “easy” as I should only have 2 small incisions and no precautions or drains like I would have if I opted for a mastectomy with reconstruction. I should mention that I’m not choosing a mastectomy for several reasons:

  • I do not have a BRCA gene mutation, therefore my risk of a local recurrence and my overall cancer survival rate is not affected by choosing a more conservative surgery.
  • As a rehab professional, I am well aware that a mastectomy is a MAJOR surgery, and the recovery is more difficult and the healing timeline can be longer.
  • Had I chosen mastectomy, I would have likely chosen to have reconstruction as well which would require multiple additional surgeries & I just don’t have the energy for all of that!

Breast-conserving surgery is my personal choice based on what I know about my cancer now. There are many reasons why someone else would choose a mastectomy. Everyone’s situation is very different so just because this seems to be the right option for me doesn’t mean it’s the right (or best) option for someone else.

I will need radiation after surgery as well and I’ll be referred to a radiation oncologist to determine the plan. I’m also going to see my PT colleague for pre-operative lymphedema measures so I have a baseline to compare to after surgery.

2 weeks Post-chemo Faux-Hawk!

My hair and eyebrows are growing in nicely! In fact, I can almost make a baby mohawk. For 3 weeks post-chemo, I’m pretty excited about that! With my eyelashes growing in, my eyes have become super irritated, but I will be SO thankful to have lashes again! I miss mascara!

If you have any questions for me about surgery, lymphedema risk, or anything related to breast cancer or physical therapy – leave a comment for me below!

Hop you all have a great weekend! My mom will be here in two days! How lucky am I?!

Aloha ❤